Do you think you're dehydrated? Did you get a BUN - blood urea nitrogen test? This can give some insight on your fluid status.

24 hour urine based cortisol test has no meaning for someone with adrenal insufficiency. One of the difficult aspects of Addisons is there are no accurate tests to track cortisol levels. I would look for another endocrinologist to help you out.

What are your symptoms that drive your stress dosing and high daily cortisol replacement dose?

BUN = 17, middle of the scale. I drink a 30 oz cup of water between each cup of coffee (or partial cup) through the workday. I don't think dehydration is an issue. Symptoms are difficult to verbalize. I typically feel a weird sensation in my cheeks, like flushing or something. It's not something I've experienced pre-addisons. Fatigue follows. Sometimes a heaviness in my chest, tightness in throat. A stress dose cures it in an hour or so. I finally left a message at my endo's nurse's line today to let them know what I've been through and the fact that i was going to try a 0.05mg, half pill, of fludro every other day. I started today at lunch and spoke to my PAC about it too. He was okay but still knows very little about Addisons. I told him he'd be learning with me. My endo has a young family and is part time. I'll give the nurse a day or two to respond. I've been with this endo for over 20 years and am very confident in her. I joke that she is writing another chapter in the Endo book just about me. I'm not text book at all in many ways. Today was a morning 5mg stress dose and a 7:10pm one as well. Less HC with the extra FC. I'll give it a few days to see a pattern.

If you think low sodium is driving the symptoms look at your kidney and liver function and check any meds you may take such as diuretics that may have impact on sodium.

Of course make sure you have good management on the thyroid and diabetes. If thyroid is not balanced will impact the adrenal insufficiency and if sugars are all over the place will cause problems.

The three conditions, autoimmune based type 1 diabetes, hypothyroidism and adrenal insufficiency, are the primary components of a syndrome called Polyglandular Autoimmune Syndrome Type II. Other less likely conditions can occur with this syndrome and all of us with PAS Type II need to be aware of these. Pernicious anemia, hypogonadism, and celiac disease are conditions to consider if you have unexplained symptoms.

Visited endo Tuesday last week. She agreed to put me on 0.15mg fludro everyday. She had considered it but the renin test I had back in the fall returned normal results so she had me stay at the 0.10mg dose once in the morning. Since on the 0.15mg I've felt fairly normal, absent of the symptoms I lived on thru Feb. In marches a head cold. I increased HC 5mg per dose (15mg total per day) for a few days. As the cold hit harder I increased to plus 10mg HC per dose. This past Monday I tried cutting back to plus 5mg thinking my cold was regressing. Tuesday I went to normal HC dosages. Yesterday I felt week and added 5mgs at 11:30am and 4pm. This morning I kept the added 5mg at 6:30am. Come 11am I started feeling the Feb symptoms again. I bumped the 11:30a HC 10mg and the 4pm plus 10mg as well. For the 4pm this is doubling. Finally at 8pm I felt close to normal. Did I under-treat my cold with HC? Should I just double with the obvious head cold symptoms? Did I taper too soon? I'm collecting lots of data on myself. Nothing wasted. Only knowledge to be gained. Tomorrow is another day. Keep it positive!